Left ventricular function in patients >20 years of age with Ebstein's anomaly of the tricuspid valve

doi:10.1016/0002-9149(91)90451-P

The American Journal of Cardiology

Volume 67, Issue 2, 15 January 1991, Pages 217-219

https://doi.org/10.1016/0002-9149(91)90451-P Get rights and content

Abstract

There have been few reports of left ventricular (LV) abnormalities in patients with Ebstein's anomaly of the tricuspid valve.^1,2 We studied LV function by echocardiography and radionuclide imaging in 8 patients >20 years of age with this abnormality.

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Cited by (14)

Effect of Operation for Ebstein Anomaly on Left Ventricular Function
2008, American Journal of Cardiology
Citation Excerpt :
Although Ebstein anomaly is generally believed to be an abnormality of the right side of the heart, there have been several reports of abnormalities of the left ventricle. These abnormalities include reduced LV function and diastolic dysfunction,2–10 LV noncompaction,2 LV dilation,2,7 LV fibrosis,7–9 and abnormal LV shape.3,6,7 We did note that in our overall cohort of patients a relatively large proportion had mitral valve prolapse.
Our objective was to examine the outcomes of patients with left ventricular (LV) dysfunction who underwent operation for Ebstein anomaly. From April 1, 1972 to January 1, 2006, 539 patients with Ebstein anomaly underwent operation at Mayo Clinic. LV function was determined by echocardiography. Of the 495 patients with preoperative echocardiographic assessment of LV function, 50 had moderate or severe LV systolic dysfunction. In patients with LV dysfunction, the tricuspid valve (TV) was repaired in 12 patients and replaced in 36 patients; 1 patient had a 1.5 ventricle repair, and 1 patient had cardiac transplantation. There were 5 early deaths (10%). LV function improved in all but 4 patients after operation. In no patient did LV function worsen after operation. The 1-, 5-, and 10-year survival was 86%, 77%, and 67%, respectively. On univariate analysis, absence of sinus rhythm at dismissal (p = 0.003) was associated with greater overall mortality. For the entire cohort of 539 patients, LV dysfunction was independently predictive of late mortality (hazard ratio 3.76, p <0.001). At late follow-up (mean 6.9 years), 86% of patients were in New York Heart Association class I or II. In conclusion, LV systolic dysfunction occurs infrequently in patients with Ebstein anomaly and is a risk factor for increased late mortality. Although early mortality is greater in patients with LV dysfunction, the late results are favorable. Decreasing LV function should be an indication to promptly restore TV competence rather than a contraindication to TV operation.
Right ventricular strain rate and strain analysis in patients with repaired tetralogy of Fallot: Possible interventricular septal compensation
2004, Journal of the American Society of Echocardiography
Indices such as strain rate (SR) and strain (ϵ) are free of geometric assumptions and, thus, may provide new insights into right ventricular (RV) function and compensatory mechanisms in repaired tetralogy of Fallot (TOF).
All those with postoperative (>1 year) TOF had echocardiography evaluation of SR and ϵ indices along the RV lateral free wall (RVFW) and the interventricular septum (IVS) in the apical 4-chamber view. Pulmonary regurgitation, pulmonary stenosis, QRS duration, RV ejection fraction, and RV dimension were also measured and compared with control subjects.
There were 15 patients with TOF (7 ± 4 years old) 6 ± 3 years remote from surgical repair and 25 control subjects (10 ± 5 years old). In the patients with TOF, systolic and diastolic SR and ϵ in the RVFW were significantly reduced but were normal in the IVS. In the RVFW, reduced systolic SR and ϵ correlated with reduced RV ejection fraction (r = −0.7 [P < .01] and −0.6 [P < .03], respectively), and poorer early diastolic SR correlated with poorer RV ejection fraction (r = 0.7, P < .01).
In patients with postoperative TOF, systolic and diastolic RV SR and ϵ were impaired in the RVFW but preserved in the IVS. We speculate that IVS myocardial function is preserved as a compensatory mechanism for impaired RVFW function.
Left ventricular function in infants and children with symptomatic Ebstein's anomaly
1994, The American Journal of Cardiology
Heart transplant in Ebstein's anomaly with endocardial fibroelastosis
1992, American Heart Journal
Major adverse events and atrial tachycardia in Ebstein's anomaly predicted by cardiovascular magnetic resonance
2018, Heart
When lithium hurts: A look at ebstein anomaly
2013, Cardiology in Review

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Brief reportLeft ventricular function in patients >20 years of age with Ebstein's anomaly of the tricuspid valve

Abstract

Am J Cardiol

Left ventricular anomalies associated with Ebstein's malformation of the tricuspid valve

Circulation

Left ventricular geometry and function in adults with Ebstein's anomaly of the tricuspid valve

Circulation

Brief report
Left ventricular function in patients >20 years of age with Ebstein's anomaly of the tricuspid valve